A perineal massage consists of massaging the area called the perineum, or the area between your anus and vagina. Perineal massages can alleviate discomfort and possibly eliminate the need for an episiotomy (an incision made in the perineum to ease the passage of the baby during a vaginal delivery). The massage can be performed either by you or your partner, and the best time to start is generally about six weeks before your due date.
Many healthcare professionals try to wait until the baby is crowning before deciding whether or not an episiotomy is necessary. In many cases, an episiotomy can be avoided if the muscles and skin around the anus and vagina are stronger than normal. Most women who do perineal massages are able to give birth vaginally, without complications or the need for an episiotomy.
Perineal Massage Benefits
There are numerous benefits associated with perineal massages:
- It strengthens the perineum
- It helps prepare the mother for the pressure and stretching that goes with birth
- It helps to make the tissue around the baby’s head more elastic when crowning
- It helps prepare the mother for the sensations that occur during birth
- It helps the mother learn to control the muscles of the vagina
- Bonding time for mother and partner
Perineal massages are said to work best for women over the age of 20 who are experiencing pregnancy for the first time.
The Perineal Massage Technique
There is a right way and wrong way to do a perineal massage. This is the correct way to give a perineal massage:
- Make sure your hands are clean and your thumbnails are trimmed
- Use a mirror at first to help you become familiar with your perineum
- Use massage oil, vegetable oil, or a water-based lubricant
- Sit in a comfortable place, with your legs spread apart in a birthing position
- Put oil on your fingers, thumbs, and on the area around the perineum
- Insert your thumbs as deeply as possible into your vagina and spread your legs
- Press the perineal area down toward the rectum and toward the sides to stretch the skin
- Gently stretch this opening until a tingle or slight burn begins
- Hold this position until the tingling or burning subsides
- Gently massage the lower part of the vagina back and forth
- While massaging, hook thumbs on the side of the vagina and gently pull the tissues forward (mimicking how the baby’s head will pull during delivery)
- Massage the tissues between the thumb and forefinger back and forth
You’ll notice the word gently keeps appearing in these steps. This is because if you use any sort of force while massaging, you can cause bruising and swelling to the sensitive tissues. Also, you want to avoid pressure on the urethra. Pressure applied to the urethra during the end of your third trimester can lead to infections.
Tips for You and Your Partner
While practicing perineal massage, you and your partner (if you have one helping with or administering this massage) should be aware of some things:
- Do not apply pressure to the top of the vagina opening
- Only massage gently
- Always seek advice from your healthcare professional
- Do not do it if you have active herpes, thrush, or another vaginal infection or problem
- Only do this is you feel comfortable
- If you are uneasy doing it in front of your partner, let him or her know
- Always keep communication lines open during the massage process
- Take a warm bath 10 – 15 minutes before the massage begins, in order to relax
- Stay away from the urethra opening to avoid urinary tract infections
- Do not start this massage technique until you are at least 34 weeks pregnant, six weeks before your due date
- Practice kegel exercises to strengthen your vaginal muscles
Are Perineal Massages for Everyone?
Absolutely not. If you have some form of a vaginal infection such as herpes, you should not proceed with this exercise. There are other exercises that strengthen your pelvic and vaginal muscles to prepare you for childbirth. For example, kegel exercises strengthen your pelvic muscles without requiring you to put your fingers in or around the vagina. This is important if you have any type of problem down there. Also, women who are not comfortable doing the massage should not proceed with it. Talk to your doctor about your discomfort to see if there are any other options.